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Indocyanine Green for Assessment of Ureteral Vascularity Can Reduce the Rate of Ureteral Complications in Patients Undergoing Extended Hysterectomy
Open accessAbstract
Objectives: This study aimed to evaluate the effectiveness of using indocyanine green (ICG) for assessing ureteral vascularity to reduce ureteral complications in patients undergoing extended hysterectomy for deep endometriosis or oncological indications. Methods: A retrospective-prospective cohort study was conducted at the Centre of Gynecology in Opole, Poland, involving 555 patients who underwent hysterectomy from 2020 to 2023. Patients were categorized based on the Querleu–Morrow classification. ICG was used intraoperatively for vascular assessment in patients with deep endometriosis undergoing wide ureter dissection typical of Type C hysterectomy. Results: Ureteral complications occurred in 12 (2.2%) patients, with a significantly lower complication rate in those who underwent ICG testing (1.7%) compared to those who did not (22.7%, p = 0.001). Prophylactic double-J stenting further reduced the risk of complications. Conclusions: The use of ICG for intraoperative assessment of ureteral vascularity significantly reduces the risk of ureteral complications in complex hysterectomies. Further studies are needed to confirm these findings.
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“Although the impact of these measures on risk reduction cannot be definitively established, no further rectoureteral fistulas were observed after introducing this preventive approach in our practice [17].”
From Surgically Relative Risk Factors for Lower Colorectal Anastomotic Dehiscence and Rectovaginal Fistulas in Complex Deep Endometriosis Cases: A Single-Center Retrospective-Prospective Cohort Study (2026) · cites this paper as [17]
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Cited by
Sorted by citations
Nowak, K., Dąbrowska, A., Mrugała, M., & Milnerowicz-Nabzdyk, E. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15072630 · Cited by 1
“Although the impact of these measures on risk reduction cannot be definitively established, no further rectoureteral fistulas were observed after introducing this preventive approach in our practice [17].”
Self-citationMrugała, M., Fiutowski, M., Dąbrowska, A., Nowak, K., & Milnerowicz-Nabzdyk, E. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15051995 · Cited by 1
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Robotic reconstruction in genitourinary tuberculosis: Surmounting technical challenges
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Metadata
- Authors
- Mrugała, M., Fiutowski, M., Nowak, K., Borowiec, Z., Kasperski, M., Bek, W., Machnicka-Rusek, A., & Milnerowicz-Nabzdyk, E.
- Affiliations
- University of Opole (PL)
- Corresponding author
- Mrugała, Maja
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2024-09-13
- Volume
- 13
- Issue
- 18
- Pages
- 5425
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC11432377
- OpenAlex
- W4402525120
- Cited by
- 4
- References
- 28
- Citations by year
- 2026: 3 · 2025: 1
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Urology › Ureteral procedures and complications
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- indocyanine green, extended hysterectomy, ureteral complications, deep infiltrating endometriosis, double-J stenting
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